Prostate and Bladder Tumors Flashcards
Epidemiology of prostate cancer
- most common malignant tumor in men (western world)
- 3rd most common cause of death (ACC 99%)
Etiology of prostate cancer
- age
- familial/genetic predisposition
- chemical (nitrate) BPH
Histology of prostate cancer
Precancerous
- prostatic intraepithelial neoplasia
- atypical adenomatous hyperplasia
Histological grading
- TRUS-guided biopsy
- Gleason score
Symptoms of prostate cancer
- asymptomatic if localized
- if not localized: dysuria, stranguria, hematuria, water retention
- metastatic: hydronephrosis, bone pain etc.
Diagnosis of prostate cancer
- DRE
- PSA blood test
- Imaging (transrectal US, bone scintigraphy, PET/CT)
Radiotherapy of prostate cancer
teletherapy/EBRT:
- 70-80 Gy
- low-risk: only prostate
- high-risk: whole pelvic
- IMRT (intensity modulated RT)
- hypofractionated RT
- combined with hormone therapy
brachytherapy:
- TRUS-guided insertion
- LDR: permanent seeds (iodine-125, palladium-103)
- HDR: temporarily inserted catheters (iridium-192)
Surgical therapy for prostate cancer
- radical prostactectomy (prostate, seminal vesical, pelvic lymph node)
- surgical orchiectomy (removal of one or more testicles) for hormone deprivation therapy
Pharmacological therapy for prostate cancer
used in metastasis: androgen deprivation therapy (ADT)
- antiandrogens: flutamide
- chemical castration: goserelin, degarelix (LHRH agonist/antagonist)
Epidemiology of bladder cancer
- 2nd most common urogenital cancer
- males at greater risk
- occurs in 60’s or 70’s
- 75-80% non-muscle invasive bladder cancer
Etiology of bladder cancer
- tobacco
- air pollution
- cychlophosphamide therapy
- parasites
- viruses
Symptoms of bladder cancer
- painless hematuria
- frequent urination
- stranguria
- lower abdominal pain
Histology of bladder cancer
urothelial:
1. papillary or flat
2. invasive or noninvasive
non-urothelial
1. planocellular
2. ACC
3. SCC
Diagnosis of bladder cancer
- abdominal palpation
- DRE
- urine cytology
- US
- cytoscopy (transurethral resection)
Radiotherapy for bladder cancer
- when surgery is not possible or patient refuses to comply
- superficial bladder cell carcinoma
- palliative symptom relief
- teletherapy
- brachytherapy
Surgical therapy for bladder cancer
surgery is the first option of therapy
- non-muscular invasive bladder cancer: transurethral resection
- muscle invasive bladder cancer: radical cystectomy + urinary diversion (stoma from ileum)
